Thursday, November 02, 2017 by Russel Davis
The efficacy of selective serotonin reuptake inhibitors (SSRI) in the treatment of depression has long been questioned within the scientific community due to varying study results. However, recent research published in the EBioMedicine journal has demonstrated that the drug’s efficacy may also be dependent on a patient’s perceptions about the treatment. As part of the study, a team of health experts at the Uppsala University in Sweden enrolled patients with social anxiety disorder who had been instructed to take similar doses of the SSRI escitalopram for nine weeks.
The researchers categorized the patients into two groups. One group received accurate information about the drug’s profile and efficacy, while the other group has been given incorrect information and were under the impression that they are taking an active placebo pill. The research team has also assessed the participant’s brain activities through an MR neuroimaging test. The results indicated a better drug response when patients are presented with the correct information.
“Our results show that the number of responders was three times higher when correct information was given than when patients thought they were treated with an ineffective active placebo, even though the pharmacological treatment was identical,” study author Vanda Faria told Science Daily online.
Data from brain scans also revealed that the drug had varying effects on both patient groups. According to the research team, the patients exhibited significant differences in the activation of the posterior cingulate cortex and the amygdala, a brain region that plays a key role in the onset of fear and anxiety. Study co-author Malin Gingnell also noted that this effect demonstrates a correlation between cognition and emotion, as brain activities tend to vary depending on a patient’s expectations.
“We don’t think SSRIs are ineffective or lack therapeutic properties for anxiety but our results suggest that the presentation of the treatment may be as important as the treatment itself,” lead investigator Professor Tomas Furmark adds.
A 2014 study published the British Journal of Psychiatry has also demonstrated how patient perception greatly affects treatment efficacy in people with depression. In order to carry out the study, a team of researchers at the University of California, Los Angeles enrolled 88 patients and assigned them into different disease interventions. Twenty patients received supportive care alone, while 29 patients underwent placebo treatment, and 39 patients took antidepressant medications. The patients were also instructed to accomplish the Hamilton Rating Scale for Depression during the study’s outset.
The results showed that patients on active antidepressant treatment exhibited an average improvement of 46 percent after eight weeks. The findings also revealed that patients in the placebo group attained an average improvement of 36 percent, compared to only five percent in those who had been assigned to supportive care alone. The experts likewise observed that patients in the supportive care treatment were more likely to discontinue treatment than those who took the oral interventions.
According to the research team, patients in the supportive care group become disappointed, knowing that they do not receive any pill. This may have contributed to their lower expectations and treatment biases, the experts have stated. (Related: Fight depression with these 15 tips you can use today.)